of 'Management and prognosis of tricuspid regurgitation'

BACKGROUND:
Despite correction of left-sided cardiac lesions, associated functional tricuspid regurgitation (TR) that was surgically ignored can persist. It can also appear de novo. The aim of this study was to analyze TR in a group of patients who underwent successful revascularization and mitral valve repair (MVRep) for functional ischemic mitral regurgitation (MR).

METHODS AND RESULTS:
Among 124 consecutive patients with MVRep, 70 left the operating room with MR<or =1+ and had a preoperative and follow-up transthoracic echocardiograph. Moderate or greater MR or TR was considered significant. Twenty-one patients (30%) had TR before surgery, and only 9 had TR repaired. The postoperative incidence of residual TR was not significantly different whether the tricuspid valve had been repaired (4 of 9 [44%]) or surgically ignored (8 of 12 [67%]). At last follow-up, 34 patients (49%) had significant TR. The incidence of TR increased from 25% at<1 year to 53% between 1 and 3 years and 74% at>3 years. Absence or presence of recurrent MR did not significantly affect TR (14 of 22 [64%]with MR versus 20 of 48 [42%]with no MR). Preoperative and postoperative tricuspid annulus size in patients with late TR was significantly larger than inpatients without TR.

CONCLUSIONS:
Functional TR is frequently associated with functional ischemic MR. After MVRep, close to 50% of patients have TR. The incidence of postoperative TR increases with time. Preoperative tricuspid annulus dilation might be a predictor of late TR.

AD

The International Heart Institute of Montana Foundation, Saint Patrick Hospital and Health Sciences Center, University of Montana, Missoula, Montana, USA.